临床与实验药理学杂志

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A Review on Prevalence and Causes of Peripheral Neuropathy and Treatment of Different Etiologic Subgroups with Neurotropic B Vitamins

Hakim M, Kurniani N, Pinzon R, Tugasworo D, Basuki M, Haddani H, Pambudi P, Fithrie A, Wuysang AD

Peripheral neuropathy (PN) is the most common disorder of the peripheral nervous system in adults, and its prevalence increases with age. Because PN is often poorly documented and strongly underdiagnosed, estimating its prevalence in the general population is difficult. Only few epidemiological studies on the prevalence of PN in the general population are available, mostly from industrialized countries. Especially in developing countries, figures from different sources vary considerably. Available data often focus on certain etiological subgroups-particularly diabetics-or on neuropathic pain (NeP), which contributes to this variation. More epidemiological prevalence studies from the general population are required to gain a better picture on sizes of patient groups and cause patterns. To provide an overview of current prevalence data, we performed a selective literature search in PubMed, Cochrane and Google Scholar and used relevant examples along with comprehensive reviews covering the past 15+ years identified through the use of the authors’ own files. These data indicate that PN is frequent and often undiagnosed for a long time. Although diabetes is the number one cause of PN worldwide, there are various causes beyond, making it hard for physicians to gain a clear patient picture and recognize symptoms. Most clinical studies also focus on diabetic PN treatment only; thus, data comparing the treatment of PN of several etiologies are rare, which contributes to the lack of awareness of PN causes. In order to demonstrate that different PN subgroups can benefit from treatment with B vitamins progressively over time-regardless of underlying PN causes, we also present some subgroup results of a recent non-interventional study (Neurobion non-interventional; NENOIN) herein. The NENOIN study showed that treating PN of different etiologies including idiopathic neuropathy is possible with a fixed dose of neurotropic B vitamins. Therefore, we conclude that this is an effective treatment option for different PN subgroups from which even patients with unknown PN causes can benefit.